Full Transcript Oral vs. Vaginal Estrogen: Which Is Safer? 0:01 If you've ever 0:01 If you've ever wondered which is 0:01 wondered which is 0:01 wondered which is safer: 0:02 safer: 0:02 safer: oral estrogen 0:03 oral estrogen 0:03 oral estrogen or vaginal estrogen, the honest 0:04 or vaginal estrogen, the honest 0:04 or vaginal estrogen, the honest answer is that 0:05 answer is that 0:05 answer is that you're asking the 0:06 you're asking the 0:06 you're asking the wrong 0:07 wrong 0:07 wrong question. And because of this 0:08 question. And because of this 0:08 question. And because of this confusion, many 0:09 confusion, many 0:09 confusion, many women after 40 are 0:10 women after 40 are 0:10 women after 40 are either afraid of certain 0:11 either afraid of certain 0:11 either afraid of certain treatments or 0:12 treatments or 0:12 treatments or use 0:13 use 0:13 use the wrong ones because 0:14 the wrong ones because 0:14 the wrong ones because they don't help. 0:15 they don't help. 0:16 they don't help. So in this video, I'm going to 0:17 So in this video, I'm going to 0:17 So in this video, I'm going to show you the real 0:18 show you the real 0:18 show you the real difference between these 0:19 difference between these 0:19 difference between these two types of 0:20 two types of 0:20 two types of estrogen. Which one 0:22 estrogen. Which one 0:22 estrogen. Which one is generally considered 0:23 is generally considered 0:23 is generally considered less risky? And 0:24 less risky? And 0:24 less risky? And how exactly do you know 0:25 how exactly do you know 0:25 how exactly do you know which one is 0:26 which one is 0:26 which one is right for you? I am Dr. 0:28 right for you? I am Dr. 0:28 right for you? I am Dr. Jen, a 0:28 Jen, a 0:29 dual- 0:29 dual- boarded OB-GYN and 0:30 boarded OB-GYN and 0:30 boarded OB-GYN and integrative 0:31 integrative 0:31 integrative medicine physician. Here's a look 0:33 medicine physician. Here's a look 0:33 medicine physician. Here's a look that radically changes the 0:34 that radically changes the 0:34 that radically changes the entire conversation. 0:34 entire conversation. 0:35 entire conversation. Oral and 0:35 Oral and 0:35 Oral and vaginal estrogen are 0:37 vaginal estrogen are not two versions of the same 0:37 not two versions of the same 0:39 treatment. They 0:39 treatment. They perform completely 0:40 perform completely 0:41 perform completely different tasks. And they
Systemic vs. Local Estrogen Explained 0:42 different tasks. And they 0:42 different tasks. And they are actually dosed 0:43 are actually dosed 0:43 are actually dosed very, very 0:44 very, very differently. So once 0:45 differently. So once 0:45 differently. So once you 0:46 you 0:46 you understand that, the 0:47 understand that, the 0:47 understand that, the security issue almost always 0:48 security issue almost always 0:48 security issue almost always resolves 0:49 resolves 0:49 resolves itself. And you'll see 0:50 itself. And you'll see 0:50 itself. And you'll see why the option 0:51 why the option 0:51 why the option most women 0:52 most women 0:52 most women fear is actually the 0:53 fear is actually the 0:53 fear is actually the safest of the 0:54 safest of the 0:54 safest of the two. Here is the main 0:56 two. Here is the main 0:56 two. Here is the main idea that reveals 0:57 idea that reveals 0:57 idea that reveals the essence: it all comes down 0:58 the essence: it all comes down 0:58 the essence: it all comes down to the concept of 0:59 to the concept of 0:59 to the concept of systemic influence 1:00 systemic influence 1:00 systemic influence versus local. 1:01 versus local. 1:03 Therefore, oral 1:04 Therefore, oral estrogen is systemic. 1:05 estrogen is systemic. 1:05 estrogen is systemic. You swallow a pill, 1:06 You swallow a pill, 1:06 You swallow a pill, it is absorbed 1:07 it is absorbed 1:07 it is absorbed through the intestines and 1:08 through the intestines and 1:08 through the intestines and distributed throughout the 1:09 distributed throughout the 1:09 distributed throughout the body, treating 1:10 body, treating 1:10 body, treating general symptoms. 1:11 general symptoms. 1:12 general symptoms. Such as hot flashes, 1:13 Such as hot flashes, 1:13 Such as hot flashes, night sweats, 1:14 night sweats, 1:14 night sweats, sleep problems, and 1:16 sleep problems, and 1:16 sleep problems, and mood swings. 1:16 mood swings. 1:17 mood swings. Vaginal estrogen 1:18 Vaginal estrogen is local. It acts 1:20 is local. It acts 1:20 is local. It acts very locally and in 1:21 very locally and in 1:21 very locally and in very low doses. 1:22 very low doses. 1:23 very low doses. These are creams, pills, 1:24 These are creams, pills, 1:24 These are creams, pills, rings. These are medications that 1:26 rings. These are medications that 1:26 rings. These are medications that you inject internally. 1:27 you inject internally. 1:27 you inject internally. You place it 1:28 You place it 1:28 You place it exactly where it is needed, 1:29 exactly where it is needed, 1:29 exactly where it is needed, where the problem is. Whether it's
How Oral Estrogen Works 1:30 where the problem is. Whether it's 1:30 where the problem is. Whether it's the vagina, the bladder, the 1:32 the vagina, the bladder, the 1:32 the vagina, the bladder, the urethra—all of these 1:33 urethra—all of these 1:33 urethra—all of these tissues are affected by 1:34 tissues are affected by 1:34 tissues are affected by vaginal estrogen 1:35 vaginal estrogen . This is what we 1:36 . This is what we 1:36 . This is what we call 1:36 call 1:36 call genitourinary 1:37 genitourinary 1:37 genitourinary syndrome of menopause, 1:39 syndrome of menopause, 1:39 syndrome of menopause, GMS. That is, everything 1:40 GMS. That is, everything 1:40 GMS. That is, everything related to the intimate 1:41 related to the intimate 1:41 related to the intimate area. And this moment is 1:42 area. And this moment is 1:42 area. And this moment is the most important for 1:43 the most important for 1:43 the most important for safety. When you 1:44 safety. When you 1:44 safety. When you ingest estrogen 1:45 ingest estrogen 1:45 ingest estrogen orally, it has to 1:47 orally, it has to 1:47 orally, it has to pass through the liver. 1:48 pass through the liver. 1:48 pass through the liver. It reaches the rest of the 1:49 It reaches the rest of the 1:49 It reaches the rest of the body after an 1:50 body after an 1:50 body after an initial 1:50 initial 1:50 initial passage through 1:51 passage through 1:51 passage through the liver. It is this 1:53 the liver. It is this 1:53 the liver. It is this initial passage 1:54 initial passage 1:54 initial passage through the liver that is the 1:55 through the liver that is the 1:55 through the liver that is the source of systemic 1:56 source of systemic 1:56 source of systemic risk. Vaginal 1:57 risk. Vaginal 1:57 risk. Vaginal estrogen, because 1:58 estrogen, because 1:58 estrogen, because the dose is very small and it 1:59 the dose is very small and it 1:59 the dose is very small and it only acts on local 2:00 only acts on local 2:00 only acts on local tissues, hardly 2:01 tissues, hardly 2:01 tissues, hardly increases the level of 2:02 increases the level of 2:02 increases the level of estrogen in the blood. 2:03 estrogen in the blood. 2:03 estrogen in the blood. Therefore, it is not 2:04 Therefore, it is not 2:04 Therefore, it is not considered systemic 2:05 considered systemic . The same 2:06 . The same 2:06 . The same hormone, but a completely 2:07 hormone, but a completely 2:07 hormone, but a completely different effect. It 2:08 different effect. It 2:08 different effect. It depends on the fabrics 2:09 depends on the fabrics 2:09 depends on the fabrics you 2:10 you 2:10 you are using it for. This 2:11 are using it for. This 2:11 are using it for. This simple fact lies at the 2:13 simple fact lies at the 2:13 simple fact lies at the heart of the 2:13 heart of the 2:13 heart of the security issue. Oral
How Vaginal Estrogen Works 2:16 security issue. Oral 2:16 security issue. Oral estrogen, the systemic 2:17 estrogen, the systemic 2:17 estrogen, the systemic option, and let's be 2:18 option, and let's be 2:18 option, and let's be honest, 2:18 honest, 2:18 honest, oral estrogen is 2:19 oral estrogen is 2:19 oral estrogen is actually very, very 2:20 actually very, very 2:20 actually very, very safe, many 2:21 safe, many 2:21 safe, many women can 2:22 women can 2:22 women can use it, it's 2:23 use it, it's 2:24 use it, it's very beneficial and 2:24 very beneficial and 2:24 very beneficial and inexpensive. If your 2:26 inexpensive. If your 2:26 inexpensive. If your main concerns are 2:27 main concerns are 2:27 main concerns are hot flashes, night 2:28 hot flashes, night 2:28 hot flashes, night sweats, 2:29 sweats, 2:29 sweats, sleep problems, or 2:30 sleep problems, or 2:30 sleep problems, or mood swings, you need 2:31 mood swings, you need 2:31 mood swings, you need systemic estrogen, and 2:32 systemic estrogen, and 2:33 systemic estrogen, and the pill can 2:33 the pill can 2:33 the pill can help with just 2:34 help with just 2:34 help with just that. This is a great 2:35 that. This is a great 2:36 that. This is a great option. But due to the 2:37 option. But due to the 2:37 option. But due to the first- 2:37 first- 2:37 first- pass effect through 2:38 pass effect through 2:38 pass effect through the liver, oral 2:39 the liver, oral 2:39 the liver, oral estrogen may slightly 2:40 estrogen may slightly 2:40 estrogen may slightly increase the risk of 2:41 increase the risk of 2:41 increase the risk of blood clots. 2:42 blood clots. 2:42 blood clots. It can also 2:43 It can also 2:43 It can also raise 2:44 raise 2:44 raise triglyceride levels and 2:45 triglyceride levels and 2:45 triglyceride levels and sometimes affect 2:46 sometimes affect 2:46 sometimes affect gallbladder function 2:46 gallbladder function 2:47 gallbladder function . And for some 2:49 . And for some 2:49 . And for some women, such a 2:49 women, such a 2:49 women, such a compromise is 2:50 compromise is 2:50 compromise is unacceptable. So, 2:52 unacceptable. So, 2:52 unacceptable. So, most healthy 2:53 most healthy 2:53 most healthy women can 2:54 women can 2:54 women can take oral 2:55 take oral 2:55 take oral estrogen without any 2:56 estrogen without any 2:56 estrogen without any problems. The risk is very, 2:57 problems. The risk is very, 2:57 problems. The risk is very, very, very 2:58 very, very 2:58 very, very minimal. For 2:59 minimal. For 2:59 minimal. For most women, it is 3:00 most women, it is 3:00 most women, it is completely safe. But 3:02 completely safe. But 3:02 completely safe. But if you have a 3:02 if you have a 3:02 if you have a personal or 3:03 personal or 3:03 personal or family history of 3:04 family history of 3:04 family history of thrombosis or other
Oral Estrogen: Benefits & Potential Risks 3:05 thrombosis or other 3:05 thrombosis or other risk factors, 3:06 risk factors, 3:06 risk factors, such as smoking 3:07 such as smoking 3:07 such as smoking and being over 40, 3:08 and being over 40, 3:08 and being over 40, you should discuss 3:09 you should discuss 3:09 you should discuss this with your doctor, 3:10 this with your doctor, 3:10 this with your doctor, as oral 3:11 as oral 3:11 as oral administration may not be 3:12 administration may not be 3:12 administration may not be suitable for you. Or you 3:13 suitable for you. Or you 3:13 suitable for you. Or you may need a 3:14 may need a 3:14 may need a full examination 3:15 full examination 3:15 full examination before you can 3:16 before you can 3:16 before you can use the 3:17 use the 3:17 use the oral route. These are 3:18 oral route. These are 3:18 oral route. These are things you 3:18 things you 3:18 things you need to discuss 3:20 need to discuss 3:20 need to discuss with your doctor, given 3:21 with your doctor, given 3:21 with your doctor, given your specific 3:22 your specific 3:22 your specific risks. But 3:23 risks. But 3:23 risks. But vaginal estrogen 3:24 vaginal estrogen is a remedy that is 3:25 is a remedy that is 3:25 is a remedy that is safe for almost 3:26 safe for almost 3:26 safe for almost everyone. I honestly 3:27 everyone. I honestly 3:27 everyone. I honestly can't imagine anyone 3:28 can't imagine anyone who wouldn't like it 3:29 who wouldn't like it 3:29 who wouldn't like it . And people are very 3:30 . And people are very 3:30 . And people are very nervous about it. 3:31 nervous about it. 3:32 nervous about it. Honestly, this is the 3:32 Honestly, this is the 3:32 Honestly, this is the option that I think 3:33 option that I think 3:33 option that I think more women would 3:34 more women would 3:34 more women would feel 3:35 feel 3:35 feel comfortable with. Even 3:35 comfortable with. Even 3:37 breast cancer patients 3:37 breast cancer patients can 3:37 can 3:37 can use 3:38 use 3:38 use vaginal estrogen 3:39 vaginal estrogen . It treats GMS— 3:40 . It treats GMS— genitourinary 3:41 genitourinary 3:41 genitourinary syndrome of menopause. These are 3:43 syndrome of menopause. These are 3:43 syndrome of menopause. These are phenomena such as 3:44 phenomena such as 3:44 phenomena such as vaginal dryness, 3:45 vaginal dryness, 3:45 vaginal dryness, burning, painful sex 3:46 burning, painful sex , irritation of the vulva 3:47 , irritation of the vulva 3:47 , irritation of the vulva and vagina, frequent 3:48 and vagina, frequent 3:48 and vagina, frequent 3:50 urinary tract infections, 3:50 urinary tract infections, urgent urges, 3:52 urgent urges, 3:52 urgent urges, symptoms when you 3:53 symptoms when you 3:53 symptoms when you feel like you need to 3:54 feel like you need to 3:54 feel like you need to go to the toilet all the time 3:56 go to the toilet all the time 3:56 go to the toilet all the time . Because the dose is 3:58 . Because the dose is 3:58 . Because the dose is tiny and acts 3:59 tiny and acts 3:59 tiny and acts locally, it does
Who Should Be Cautious With Oral Estrogen? 4:00 locally, it does 4:00 locally, it does its job 4:01 its job 4:01 its job without increasing 4:02 without increasing 4:02 without increasing hormone levels throughout the 4:03 hormone levels throughout the 4:03 hormone levels throughout the body. 4:04 body. 4:07 Major menopause guidelines 4:09 recognize low-dose 4:09 recognize low-dose vaginal 4:10 vaginal 4:10 vaginal estrogen as safe 4:11 estrogen as safe 4:11 estrogen as safe for almost everyone. But there is a 4:13 for almost everyone. But there is a 4:13 for almost everyone. But there is a caveat: because it 4:14 caveat: because it 4:14 caveat: because it acts locally, it will not 4:15 acts locally, it will not 4:15 acts locally, it will not eliminate your systemic 4:16 eliminate your systemic 4:16 eliminate your systemic symptoms, such as 4:17 symptoms, such as 4:17 symptoms, such as hot flashes. It won't 4:18 hot flashes. It won't 4:18 hot flashes. It won't protect your bones, it won't 4:19 protect your bones, it won't 4:20 protect your bones, it won't protect your brain, and it 4:21 protect your brain, and it 4:21 protect your brain, and it won't help with 4:21 won't help with 4:21 won't help with problems that are 4:23 problems that are 4:23 problems that are systemic in nature. 4:24 systemic in nature. 4:25 systemic in nature. This is what 4:26 This is what 4:26 This is what most people don't 4:27 most people don't 4:27 most people don't tell you. 4:28 tell you. 4:28 tell you. There is actually a third option 4:29 There is actually a third option 4:29 There is actually a third option that addresses 4:30 that addresses 4:30 that addresses safety concerns and 4:31 safety concerns and 4:31 safety concerns and concerns for 4:32 concerns for 4:32 concerns for many women and 4:33 many women and 4:33 many women and provides them with the 4:33 provides them with the 4:33 provides them with the systemic estrogen 4:34 systemic estrogen 4:34 systemic estrogen they 4:35 they 4:35 they need. And that's what 4:36 need. And that's what 4:36 need. And that's what I want to 4:37 I want to 4:37 I want to talk about in the 4:38 talk about in the 4:38 talk about in the next 60 seconds. 4:39 next 60 seconds. 4:39 next 60 seconds. So stay with 4:40 So stay with 4:40 So stay with me because this 4:41 me because this 4:41 me because this part might be the 4:42 part might be the 4:42 part might be the right choice 4:43 right choice 4:43 right choice for you. So, 4:44 for you. So, 4:44 for you. So, this third option is
Why Vaginal Estrogen Is Considered Low-Dose & Local 4:45 this third option is transdermal. 4:46 transdermal. 4:47 transdermal. So, it is indeed 4:47 So, it is indeed 4:47 So, it is indeed systemic estrogen 4:49 systemic estrogen 4:49 systemic estrogen for hot flashes, 4:49 for hot flashes, 4:49 for hot flashes, night 4:50 night 4:50 night sweats, and 4:51 sweats, and 4:51 sweats, and sleep problems, but 4:52 sleep problems, but 4:52 sleep problems, but the risk of thrombosis 4:53 the risk of thrombosis 4:53 the risk of thrombosis similar to that of 4:54 similar to that of 4:54 similar to that of taking the 4:55 taking the 4:55 taking the pill is absent from the 4:56 pill is absent from the 4:56 pill is absent from the transdermal 4:57 transdermal 4:57 transdermal options. So if 4:59 options. So if 4:59 options. So if you want a systemic 5:00 you want a systemic 5:00 you want a systemic oral option 5:01 oral option 5:01 oral option but can't because of the 5:02 but can't because of the 5:02 but can't because of the risk of thrombosis, this 5:03 risk of thrombosis, this 5:03 risk of thrombosis, this may be an 5:04 may be an 5:04 may be an even better 5:05 even better 5:05 even better choice for you. And some 5:06 choice for you. And some 5:06 choice for you. And some women simply 5:06 women simply 5:06 women simply choose the 5:07 choose the 5:07 choose the transdermal 5:08 transdermal 5:08 transdermal method because they don't want 5:09 method because they don't want 5:09 method because they don't want to remember to 5:10 to remember to 5:10 to remember to take medication every day. 5:10 take medication every day. 5:11 take medication every day. Transdermal 5:12 Transdermal 5:12 Transdermal agents are essentially 5:13 agents are essentially 5:13 agents are essentially patches, gels, 5:14 patches, gels, 5:14 patches, gels, aerosols, or sprays. 5:16 aerosols, or sprays. 5:16 aerosols, or sprays. Because they 5:17 Because they 5:17 Because they are absorbed through 5:18 are absorbed through 5:18 are absorbed through the skin and bypass 5:19 the skin and bypass 5:19 the skin and bypass primary metabolism 5:20 primary metabolism 5:20 primary metabolism in the liver, 5:21 in the liver, 5:21 in the liver, transdermal 5:22 transdermal 5:22 transdermal estrogens do not carry the 5:23 estrogens do not carry the 5:23 estrogens do not carry the same risk of 5:24 same risk of 5:24 same risk of thrombosis as 5:25 thrombosis as 5:25 thrombosis as oral estrogens. When I 5:26 oral estrogens. When I 5:26 oral estrogens. When I say this, I mean the 5:27 say this, I mean the 5:27 say this, I mean the formation of 5:28 formation of 5:28 formation of blood clots. So 5:29 blood clots. So 5:29 blood clots. So for many women, the 5:30 for many women, the 5:30 for many women, the safest 5:31 safest 5:31 safest systemic choice is 5:32 systemic choice is 5:32 systemic choice is not pills, but a 5:33 not pills, but a 5:33 not pills, but a patch or gel. 5:34 patch or gel. 5:34 patch or gel. Both options are
What Vaginal Estrogen Can & Can't Treat 5:35 Both options are 5:35 Both options are FDA-approved, and there are 5:36 FDA-approved, and there are 5:36 FDA-approved, and there are many affordable 5:37 many affordable 5:37 many affordable options that can be 5:38 options that can be 5:38 options that can be purchased with 5:38 purchased with 5:38 purchased with insurance, and if not, there 5:40 insurance, and if not, there 5:40 insurance, and if not, there are also great 5:41 are also great 5:41 are also great combination options 5:42 combination options . I 5:43 . I 5:43 . I will discuss this comparison in detail in 5:44 will discuss this comparison in detail in 5:44 will discuss this comparison in detail in another video. This is something to 5:45 another video. This is something to 5:45 another video. This is something to know before 5:46 know before 5:46 know before you get a prescription. 5:47 you get a prescription. 5:48 you get a prescription. This video is about 5:48 This video is about 5:48 This video is about estradiol gel 5:49 estradiol gel 5:49 estradiol gel vs. 5:50 vs. 5:50 vs. transdermal 5:51 transdermal 5:51 transdermal gel. I also made a 5:52 gel. I also made a 5:52 gel. I also made a separate video about 5:53 separate video about 5:53 separate video about different options for 5:54 different options for 5:54 different options for hormone replacement 5:55 hormone replacement 5:55 hormone replacement therapy. Here is 5:56 therapy. Here is 5:56 therapy. Here is the link if you are 5:57 the link if you are 5:57 the link if you are interested. 5:58 interested. 6:00 Transdermal gel 6:00 Transdermal gel or patch does not 6:01 or patch does not 6:01 or patch does not burden the liver 6:02 burden the liver , so you can 6:03 , so you can 6:03 , so you can use 6:04 use 6:04 use estrogen both systemically 6:05 estrogen both systemically 6:05 estrogen both systemically and vaginally. 6:06 and vaginally. 6:07 and vaginally. In fact, this very 6:08 In fact, this very 6:08 In fact, this very warning was 6:10 warning was 6:10 warning was removed by the FDA in 2023. 6:12 removed by the FDA in 2023. 6:14 Therefore, it is important to know 6:14 Therefore, it is important to know that the systemic and
The Third Option: Transdermal Estrogen 6:15 that the systemic and 6:15 that the systemic and vaginal options 6:16 vaginal options 6:17 vaginal options can be 6:17 can be 6:17 can be used 6:18 used 6:18 used together. It's not a choice between 6:20 together. It's not a choice between 6:20 together. It's not a choice between one thing or 6:21 one thing or 6:21 one thing or another. Many women 6:22 another. Many women 6:22 another. Many women use 6:23 use 6:23 use systemic estrogen 6:24 systemic estrogen 6:24 systemic estrogen for symptoms like 6:24 for symptoms like 6:24 for symptoms like hot flashes, night 6:25 hot flashes, night 6:25 hot flashes, night sweats, and 6:26 sweats, and 6:26 sweats, and sleep problems, but 6:27 sleep problems, but 6:27 sleep problems, but they also 6:27 they also 6:27 they also use 6:28 use 6:28 use low-dose 6:29 low-dose 6:29 low-dose vaginal estrogen 6:30 vaginal estrogen 6:30 vaginal estrogen for dryness, burning, 6:31 for dryness, burning, 6:31 for dryness, burning, pain during sex, and 6:32 pain during sex, and 6:32 pain during sex, and just to feel 6:32 just to feel 6:32 just to feel better 6:33 better 6:33 better , right 6:34 , right 6:34 , right ? When it comes to urinary 6:35 ? When it comes to urinary 6:35 ? When it comes to urinary symptoms, there's 6:35 symptoms, there's 6:35 symptoms, there's nothing worse than 6:36 nothing worse than 6:36 nothing worse than recurring 6:37 recurring 6:37 recurring urinary tract infections 6:38 urinary tract infections 6:38 urinary tract infections or the constant 6:38 or the constant 6:38 or the constant feeling of 6:38 feeling of 6:38 feeling of having to go to the 6:39 having to go to the 6:39 having to go to the bathroom. And this is a very 6:40 bathroom. And this is a very 6:40 bathroom. And this is a very common phenomenon. You will not 6:41 common phenomenon. You will not 6:41 common phenomenon. You will not 6:43 overdose or 6:43 overdose or overtreat 6:44 overtreat 6:44 overtreat from combining both 6:44 from combining both 6:44 from combining both remedies. Of course, you 6:45 remedies. Of course, you 6:45 remedies. Of course, you may experience 6:46 may experience 6:46 may experience side effects from 6:47 side effects from 6:47 side effects from either of them, and your 6:48 either of them, and your 6:48 either of them, and your doses may 6:49 doses may 6:49 doses may need to be 6:49 need to be 6:49 need to be adjusted, but 6:50 adjusted, but 6:50 adjusted, but taking two medications 6:51 taking two medications 6:51 taking two medications at the same time is not 6:51 at the same time is not 6:51 at the same time is not contraindicated. 6:52 contraindicated. 6:52 contraindicated. One last thing I'll point out: The 6:53 One last thing I'll point out: The 6:53 One last thing I'll point out: The warning 6:54 warning 6:54 warning label that the FDA 6:55 label that the FDA 6:55 label that the FDA implemented through the 6:56 implemented through the 6:58 Women's 6:58 Women's Health Initiative study 23 years ago 6:59 Health Initiative study 23 years ago 6:59 Health Initiative study 23 years ago stated that all
Can You Use Systemic & Vaginal Estrogen Together? 7:01 stated that all 7:01 stated that all estrogens 7:02 estrogens 7:02 estrogens could potentially cause 7:03 could potentially cause 7:03 could potentially cause blood clots, breast cancer, and 7:04 blood clots, breast cancer, and 7:04 blood clots, breast cancer, and stroke. This label 7:06 stroke. This label 7:06 stroke. This label was removed in 7:07 was removed in 7:07 was removed in November 2025. I 7:08 November 2025. I 7:08 November 2025. I made a special 7:09 made a special 7:09 made a special video about it, so you 7:10 video about it, so you 7:10 video about it, so you can 7:11 can 7:11 can watch it. And the 7:12 watch it. And the 7:12 watch it. And the reason it was 7:13 reason it was 7:13 reason it was removed is because you 7:14 removed is because you 7:14 removed is because you can't 7:15 can't 7:15 can't just 7:15 just 7:15 just say that all 7:16 say that all 7:16 say that all estrogens cause 7:17 estrogens cause 7:17 estrogens cause these problems. This data 7:19 these problems. This data 7:19 these problems. This data was reviewed, and 7:20 was reviewed, and 7:20 was reviewed, and we realized that 7:21 we realized that 7:21 we realized that there are specific 7:22 there are specific 7:22 there are specific risks for different 7:23 risks for different 7:23 risks for different routes of administration and 7:24 routes of administration and 7:24 routes of administration and different types of 7:25 different types of 7:25 different types of estrogen. So this 7:28 estrogen. So this 7:28 estrogen. So this should be discussed 7:29 should be discussed 7:29 should be discussed with your doctor to 7:30 with your doctor to 7:30 with your doctor to find the right 7:31 find the right 7:31 find the right dose for you. 7:32 dose for you. 7:35 The mistake caused by 7:35 The mistake caused by that study 7:36 that study 7:36 that study scared many 7:37 scared many 7:37 scared many women away from a safe, 7:38 women away from a safe, 7:38 women away from a safe, life-saving 7:39 life-saving 7:39 life-saving medication, and now it is 7:40 medication, and now it is 7:40 medication, and now it is finally being 7:40 finally being 7:40 finally being 7:42 properly addressed so that 7:42 properly addressed so that women can safely 7:43 women can safely 7:43 women can safely take both 7:44 take both 7:44 take both systemic and
Understanding Estrogen Safety & FDA Warning Changes 7:45 systemic and 7:45 systemic and vaginal estrogen 7:46 vaginal estrogen without having to choose 7:47 without having to choose 7:47 without having to choose one over the other. So, hot flashes, 7:49 one over the other. So, hot flashes, 7:49 one over the other. So, hot flashes, night sweats, 7:50 night sweats, 7:50 night sweats, mood swings, 7:52 mood swings, 7:52 mood swings, bone and 7:53 bone and 7:53 bone and brain protection—all of these 7:53 brain protection—all of these 7:53 brain protection—all of these are treated with systemic 7:55 are treated with systemic 7:55 are treated with systemic estrogens via 7:56 estrogens via 7:56 estrogens via transdermal or 7:57 transdermal or 7:57 transdermal or oral routes. And 7:59 oral routes. And 7:59 oral routes. And local symptoms, 8:00 local symptoms, 8:00 local symptoms, such as vaginal 8:01 such as vaginal 8:01 such as vaginal dryness, pain during 8:02 dryness, pain during 8:02 dryness, pain during sex, and recurrent 8:03 sex, and recurrent 8:03 sex, and recurrent 8:05 urinary tract infections, 8:05 urinary tract infections, can be eliminated with 8:06 can be eliminated with 8:06 can be eliminated with low-dose 8:07 low-dose 8:07 low-dose vaginal 8:07 vaginal 8:07 vaginal estrogen. Both 8:08 estrogen. Both 8:08 estrogen. Both types of symptoms are 8:09 types of symptoms are 8:09 types of symptoms are treatable, and you can 8:10 treatable, and you can 8:10 treatable, and you can use 8:11 use 8:11 use both remedies. If 8:12 both remedies. If 8:12 both remedies. If you have a history of 8:14 you have a history of 8:14 you have a history of breast cancer or 8:15 breast cancer or 8:15 breast cancer or thrombosis, please 8:16 thrombosis, please 8:16 thrombosis, please discuss this 8:17 discuss this 8:17 discuss this individually with 8:18 individually with 8:18 individually with your doctor, 8:19 your doctor, 8:19 your doctor, as there are many 8:20 as there are many 8:20 as there are many nuances regarding your 8:21 nuances regarding your 8:21 nuances regarding your treatment. What does 8:23 treatment. What does 8:23 treatment. What does your 8:24 your 8:24 your oncologist think about the 8:25 oncologist think about the 8:25 oncologist think about the next steps in this regard? 8:26 next steps in this regard? 8:28 It is important to have a good, 8:28 It is important to have a good, organized 8:29 organized 8:29 organized treatment plan and to keep all
Choosing the Right Estrogen for Your Symptoms & Risk Profile 8:31 treatment plan and to keep all 8:31 treatment plan and to keep all your doctors 8:32 your doctors 8:32 your doctors informed. So if you 8:34 informed. So if you 8:34 informed. So if you remember one thing from 8:35 remember one thing from 8:35 remember one thing from this video, let it 8:36 this video, let it 8:36 this video, let it be this. 8:37 be this. 8:37 be this. The safest 8:38 The safest 8:38 The safest estrogen is the one that 8:39 estrogen is the one that 8:39 estrogen is the one that matches your 8:40 matches your 8:40 matches your symptoms and 8:41 symptoms and 8:41 symptoms and risk profile. Local 8:42 risk profile. Local 8:42 risk profile. Local problems require 8:43 problems require 8:43 problems require topical estrogen, 8:44 topical estrogen, 8:44 topical estrogen, such as 8:45 such as 8:45 such as low-dose 8:46 low-dose 8:46 low-dose vaginal 8:47 vaginal 8:47 vaginal estrogen in the form of 8:48 estrogen in the form of 8:48 estrogen in the form of gels, creams, or 8:49 gels, creams, or 8:49 gels, creams, or tablets. And 8:50 tablets. And 8:50 tablets. And oral and 8:51 oral and 8:51 oral and transdermal 8:51 transdermal 8:51 transdermal options 8:52 options 8:52 options are used for 8:53 are used for 8:53 are used for systemic problems. 8:54 systemic problems. 8:54 systemic problems. Safety is important, but it's 8:55 Safety is important, but it's 8:55 Safety is important, but it's important to understand that 8:56 important to understand that 8:56 important to understand that it's about the 8:57 it's about the 8:57 it's about the big picture and 8:58 big picture and 8:58 big picture and choosing the right 8:59 choosing the right 8:59 choosing the right tool. Good. 9:01 tool. Good. 9:01 tool. Good. Now that you know the 9:02 Now that you know the 9:02 Now that you know the real story behind the 9:03 real story behind the 9:03 real story behind the warning 9:04 warning 9:04 warning label on 9:04 label on 9:04 label on vaginal 9:05 vaginal 9:05 vaginal estrogen. If you 9:06 estrogen. If you 9:06 estrogen. If you want to explore hormone replacement therapy options in more depth, 9:06 want to explore hormone replacement therapy options in more depth, 9:09 watch my 9:10 watch my video, " 9:10 video, " 9:10 video, " Hormone Replacement Therapy: A 9:11 Hormone Replacement Therapy: A 9:11 Hormone Replacement Therapy: A Doctor's Guide." That's it for now 9:12 Doctor's Guide." That's it for now 9:12 Doctor's Guide." That's it for now and I'll 9:13 and I'll 9:13 and I'll see you in the 9:14 see you in the 9:14 see you in the next video.
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